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Old 09-09-2006, 07:35 PM   #1
Dan Wolfe
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Join Date: Sep 2006
Location: Indianapolis  Indiana
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A few months ago I saw an orthopedic surgeon because of wrist pain. I feared that I was developing Osteo arthritis (which it turns out I was). I also have something called Kienbock's Disease, which is a syndrome wherein the blood vessel to the lunate bone ( one of the carpal bone in the wrist) gets impeded and results in the death of the lunate bone.They refer to this as avascular necrosis of the lunate. This, in turn wreaks havock with the wrist joint and often ends up with the wrist joint being surgically frozen with a rod in the straight position. No more bending.

The surgeon estimates that I may milk 2 or 3 years out of the joint before something needs to be done surgically. I am on anti-inflammatory drugs now (started on Celebrex and did nottolerate it,then Relefin now tylenol and aspirin) I am still working out and do about 4 hours of freight handling at the FedEx Hub here 5 nights per week. On bad days, the joint feels like it is sprained. I have lost most of the dorsal flexibility of the wrist and can not support weight on my flat palm. I have modified workouts to use pushup bars which makes it possible to do many upper body exercises. Pulling movements are okay except pain in the wrist joint causes my grip to give out. Apparently loss of grip strength in also a common problem with Kienbock's.

Any thoughts or experience with this problem?

I don't want this to sideline me. Any suggestions for substitute exercises?

Anyone with ideas or experience with long term use of Anti-inflammatory drugs? Any thoughts on supplements that would help (Glucosamine and Chondroitin did not seem to help and also seemed to bloat me up.)

On bad days, I will resort to a wrist brace. Any thoughts on this or suggestions of a good brace? I have considered the possibility of parlaying this into an excuse to wear some sort of super hero gauntlet ala Ironman or Dr. Doom.

All joking aside this whole thing sucks and I am really trying to fight it. Any thoughts, suggestions or referals for information would be appreciated.

Thank you for your help.

Dan Wolfe}}}
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Old 09-09-2006, 09:26 PM   #2
Robert Wolf
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First, howdy from another wolf!

Second, that sounds pretty rough. If inflammation is an issue I'd highly recomend a Zone diet with 5-10g of fishoil/day. Clear this with your doc if you are on celebrex or any other antiinflamatory.

If inflammation is the primary concern this shoudl help but if impingement is the causative factor...need to fand a way around that. Is there any history of a microvascualr surgeon re-routing the impinged vascular bed? For most people a fused wrist "sux" but is not that big a deal. For the active and athletic its almost like loosing the limb. Email Kelly Starrett of CF San Francisco and see if he has any ideas. That guy has more brains in his thumb than I or five generations of my progeny will have.

keep us posted
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Old 09-10-2006, 05:28 AM   #3
Dan Wolfe
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Location: Indianapolis  Indiana
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Thanks for the response.

My doctor seems to be ruling out a lot of surgical options because of the Osteo arthritis present in the joint. He feels the osteo is a by-product of the Kienbocks. Some surgeons have tried revascularization. My Doctor does not seem to think it works.His POA, for now, is to monitor things, maybe do artheroscopic surgery to clean up the joint, and wait for the Kienbocks to progress at which point he would fuse the wrist joint. I guess the fact I'm posting would indicate I am not sold on this plan. I don't want surgery that is going to make things worse, but I also don't want to just wait until nothing can be done but a joint fusion. I have researched the condition and a number of other surgeries have been used with varying success including revasclarization attempts, shortening of the radius and bone fusion. Seems that most patients end up with a "salvage" procedure which is usually fusion.

I agree that wrist fusion would suck for most people. I like to work out, mountain bike and be active. The days where I have been forced to wear a splint have given a little preview of how limiting fusion would be. As it stands, I can't do a push up without using the bars, properly get a bar in the clean position, or put much weight on my palm. My range of motion is limited (I'm not clear whether it is impingement or swelling-or both) and that already cuts out a number of exercise movements and activites.

Here is link to more info on Kienbock's

I have been taking fish oil for years. Cutting out carbs does seem to help with the inflammation. Wondered if anyone had other ideas about reducing inflammation.

Thanks again for the info,

Dan Wolfe
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Old 09-10-2006, 05:41 AM   #4
Mike ODonnell
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Location: Atlanta  GA
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Not a doctor but as far as reducing inflammation you have to look at 2 factors. One the level of omega 6 or proinflammatory in your diet (high in modern beef, meats, eggs). Switch over to grass fed, organic eggs, that kind of stuff. Stay away from grain fed. Also if 5g of fish oil doesnt make a difference you may need a higher dosage. Most people without serious inflammation take 5g a day...if you have more inflammation 10g or more may be needed...always check with your doc before going too high however. Getting rid of the sugars and processed foods will help of course.

As Dr G would say too, you need your gut in shape too. In other words get a good probiotic and use some digestive enzymes. Once the gut starts to get back to normal, it's amazing to see what healing can happen all over the body. (I know several people with arthritis in their hands who swear by taking a shot of apple cider vinegar 2x a day...and that helps with the gut bacteria balance.). I believe most NDs will tell you that healing begins in the gut...and I am a true believer of that (consider that you have to use the gut to absorb all food, minerals, vitamins and the fish oil...and if it's not working properly who's to say how much of that fish oil is actually being absorbed and used in the body).

You could try the BED book,

Hope this helps somewhat.
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Old 09-10-2006, 11:34 AM   #5
Garrett Smith
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Join Date: Apr 2005
Location: Tucson  AZ
Posts: 2,264
Definitely look into Mike's suggestions...:wink:

Also, I cannot suggest enough that you pursue treatment with low intensity laser therapy. Angiogenesis and tissue healing are two of the well-documented effects of this sort of treatment. See and this study in particular may interest you .

Make sure you are getting enough vitamin C from whole food sources as well.
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Old 09-10-2006, 02:46 PM   #6
Elliot Royce
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Join Date: Mar 2006
Location: Inowa  KS
Posts: 922
Tylenol and aspirin are not anti-inflammatories to my knowledge. Are you sure Celebrex was a problem? I've been on it for about 4 years with no issues. If it was, Ibuprofen is a better choice than tylenol or aspirin because it is anti-inflammatory. Have your doctor tell you the prescription dose (much higher than the bottle says). It can cause stomach irritation.

I would check in with some other surgeons particularly sports orthopedists with a strong reputation. In my experience with hip arthritis, I found that most doctors are not oriented towards athletes and therefore do not bother to know all the possible treatments that would allow an athlete to be effective.

I found the glucosamine/chondroitin to be effective. some studies question its effectiveness but it shouldn't do any harm. Remember that it takes around 3 months to notice any effect. I have no idea why you would feel bloated from it. It's not that strong.
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